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Clearinghouses Can Help You Prepare for ICD-10, so Leverage Them!

Posted Tuesday, July 16th, 2013 by Ken Bradley

Clearinghouses helped practices significantly during the recent transition to Version 5010 of the electronic transaction standards. For example, as intermediaries between practices and payers, clearinghouses could convert any 4010 claims from a practice into 5010 before sending them on to payers. Although clearinghouses can’t convert ICD-9 codes into ICD-10, don’t forget that they still can play a valuable role in the ICD-10 transition, says the Centers for Medicare & Medicaid Services (CMS).

In particular, clearinghouses can offer the kind of data you need to proactively identify ICD-10 problems that might lead to claims rejections and denials. Furthermore, clearinghouses can give you useful guidance about how to fix and prevent problems that keep claims from being processed and paid as expected says CMS.

While clearinghouses can’t provide the same level of conversion support for ICD-10 as they did for 5010, they can still help you prepare. For more about CMS’ view of the role of clearinghouses in the ICD-10 transition – as well as a list of questions you should be asking your clearinghouse about ICD-10 readiness – check out this Government Health IT article.